Knee Surgery Does Not Improve Arthritis Outcomes

Meniscal damage may not be correlated with arthritis or joint problems

WEDNESDAY, Sept. 10 (HealthDay News) -- Arthroscopic surgery does not improve outcomes in patients with osteoarthritis of the knee, and meniscal damage in the knee is not necessarily correlated with arthritis or joint problems, according to two studies published in the Sept. 11 issue of the New England Journal of Medicine.

In the first study, Alexandra Kirkley, M.D., from the University of Western Ontario in London, Ontario, Canada, and colleagues treated 178 patients with osteoarthritis of the knee with physical therapy and medications. Of these, 86 also received surgery consisting of lavage and arthroscopic debridement. The researchers found that although both groups had similar improvements in joint pain, stiffness and function, surgery did not provide any additional benefit.

In the second study, Martin Englund, M.D., Ph.D., from Boston University School of Medicine, and colleagues used MRI to determine the integrity of the menisci in the right knee in 991 randomly chosen, 50- to 90-year-old ambulatory individuals. The researchers found that the prevalence of meniscal damage ranged from 19 to 56 percent depending on gender and age. The presence of meniscal damage was similar among those with evidence of osteoarthritis with or without knee or joint problems (63 versus 60 percent), and among those without evidence of arthritis with and without knee or joint problems (32 versus 23 percent).

"The study by Kirkley et al., combined with other evidence, indicates that osteoarthritis of the knee (in the absence of a history and physical examination suggesting meniscal or other findings) is not an indication for arthroscopic surgery and indeed has been associated with inferior outcomes after arthroscopic knee surgery," Robert G. Marx, M.D., from Weill Medical College of Cornell University in New York City, writes in an accompanying editorial.

Abstract - Kirkley
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Abstract - Englund
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